Messer J, Burtscher A, Haddad J, Casanova R, Juif J G
Services de Pédiatrie 2, CHU de Hautepierre, Strasbourg.
Arch Fr Pediatr. 1990 Nov;47(9):647-51.
Brain death can be characterized by cessation of cerebral blood flow. We have measured blood flow velocity in cerebral arteries of 17 comatous children with a transcranial pulsed Doppler equipment. In 11 children who progressed to brain death, we have recorded a progressive decrease of Doppler signal with the following steps: decrease of diastolic velocity, no diastolic velocity, reverse diastolic flow, decrease of systolic signal, no signal at all. In the 6 surviving children (all except one with severe deficits), after an initial reduction but never to a retrograde flow, arterial cerebral blood flow velocity increased to high diastolic values before normalization. Transcranial Doppler technique is non invasive, reliable, can be used at the bedside and repeated; it allows evaluating the cerebral blood flow in comatous children and represents a useful adjunct to brain death diagnosis.
脑死亡的特征可以是脑血流停止。我们使用经颅脉冲多普勒设备测量了17名昏迷儿童脑动脉中的血流速度。在进展为脑死亡的11名儿童中，我们记录到多普勒信号呈以下步骤逐渐降低：舒张期速度降低、无舒张期速度、舒张期血流逆转、收缩期信号降低、完全无信号。在6名存活的儿童（除1名有严重缺陷外）中，脑动脉血流速度在最初降低但从未出现逆行血流后，在恢复正常之前增加到高舒张期值。经颅多普勒技术是非侵入性的、可靠的，可以在床边使用且可重复；它可以评估昏迷儿童的脑血流，是脑死亡诊断的有用辅助手段。
